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Query: UMLS:C0022104 (irritable bowel syndrome)
 8,033 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

16 patients with an irritable colon were examined psychologically and independent of the result of the diagnostics of neuroses additionally distributed to two groups of treatment. One group was treated symptomatically, the other additionally psychotherapeutically (above all with autogenous training). Two thirds of the patients showed a neurosis. Psychotherapy was very useful only in those patients with a neurosis, measured as the result of the treatment one year after the beginning of the therapy. When an obstinate irritable colon is present, a diagnostics of neuroses is indicated. If a neurosis is proved, an individual psychotherapy is indicated, in which case the autogenous training as basis therapy apparently stood the test.
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PMID:[Psychotherapy of irritable colon]. 400 49

Previous studies suggest that the ways in which parents respond to children's health complaints (reinforcement) and the ways in which they cope with their own illnesses (modeling) influence the frequency of symptoms, disability days, and health care visits made by these children when they grow up. However, previous studies have not controlled for the mediating influence of stress, neuroticism, and physical examination findings. This study investigated the influence of childhood social learning on adult illness behavior in 383 women aged 20 to 40 years. Illness behavior was measured prospectively for 12 months by the frequency of symptoms, disability days, and physician visits for menstrual, bowel, and cold (upper respiratory) symptoms. Childhood reinforcement and modeling was measured retrospectively by validated questionnaires. Other independent variables were stress, neuroticism, and selected demographic variables. Multiple regression analysis was used to assess the relative contribution of each independent variable to each category of illness behavior. The principal findings were as follows. First, childhood reinforcement of menstrual illness behavior significantly predicted adult menstrual symptoms and disability days, and childhood reinforcement of cold illness behavior significantly predicted adult cold symptoms and disability days. These effects were independent of stress and neuroticism. Second, childhood reinforcement scales were useful to predict which functional disorders (dysmenorrhea or irritable bowel syndrome) these subjects had even after we controlled for stress and neuroticism.
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PMID:Modeling and reinforcement of the sick role during childhood predicts adult illness behavior. 787 Nov 10

The subject of aged people and stress was discussed from both clinical and basic points of view, mainly by introducing our research results, beginning with our immunoneuroendocrine studies on aging and stress. Stress stimulates the secretion of two adrenal hormones, cortisol and dehydroepiandrosterone-sulfate (DHEA-S). Both hormones are metabolized and excreted from the kidney, respectively converting to 17-OHCS and 17-KS-S in the urine. We have found that the two adrenal steroids reflect the physiology and pathophysiology of stress and aging, thereby suggesting that the simultaneous analysis of these parameters could be utilized as new biological markers for stress and aging. It was speculated that a disturbed balance between cortisol and DHEA-S would result in various aging- and stress-related disorders. Furthermore, clinical problems in aged people with stress-related diseases such as psychosomatic diseases, neurosis and depression were illustrated by some interesting cases. In particular, much data about peptic ulcer disease in the aged, a typical psychosomatic disease, were presented. In addition, clinical characteristics of old people with irritable bowel syndrome, aerophagia, neurogenic abdominal distention and depression were described. Data of our research to determine why pancreatic cancer is accompanied with depression so frequently were also presented. Finally, it was emphasized that a holistic approach, paying to sufficient attention to psychosomatic aspects, is very important for the management of stress diseases in the aged.
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PMID:[Aged people and stress]. 802 98

The aims of this study were to determine the impact of irritable bowel syndrome on quality of life using a well-standardized measure, the SF-36, and to determine whether apparent impairments may be due to neuroticism. Undergraduate students with irritable bowel syndrome who had consulted a physician (41 females, 42 males), students with irritable bowel who had not consulted a physician (91 females, 74 males), and asymptomatic controls (52 females, 70 males) completed questionnaires on quality of life, neuroticism, and psychological distress. Patients showed greater impairment in quality of life than nonconsulters, who in turn showed greater impairment than controls. Neuroticism and psychological distress were correlated with all quality-of-life measures. However, when neuroticism and psychological distress were statistically partialed out, irritable bowel syndrome still had a significant negative impact. The SF-36 may be a useful outcome measure in treatment studies, but investigators will need to correct for confounding influences of neuroticism.
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PMID:Impact of irritable bowel syndrome on quality of life. 894 80

Functional disorders like functional dyspepsia, irritable bowel syndrome and non-cardiac chest pain are common diseases. No organic lesion can be found to explain the often disabling symptoms. Typical features of functional dyspepsia are anxiety, depression, neuroticism, visceral hypersensitivity, abnormal autonomic nerve activity with a weak vagal and an higher sympathetic tone, and impairment of gastric accommodation. This last abnormality may be due to weak vagal tone and poor adaptive relaxation of the proximal stomach. The degree of dysfunction of the variables is sometimes correlated, suggesting that the pathogenetic factors may be interacting in a viscious circle. Medical therapy is often unsuccessful, but extensive research in the field has given better insight into the pathophysiological mechanisms, giving hope for new therapeutic modalities, including visceral analgesics. It may still be difficult, however, to distinguish organic from functional disorders. Reliable tests of visceral hypersensitivity would be helpful in this respect.
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PMID:[When you get a gut feeling...]. 901 85

Hindi adaptation of the Middlesex Hospital Questionnaire (MHQ), Brief Psychiatric Rating Scale and Presumptive Stressful Life Events Scale were used to measure neuroticism, psychiatric morbidity and stressful life events in 35 patients with non-ulcer dyspepsia (NUD), 22 cass of peptic ulcer disease (PUD), 65 irritable bowel syndrome (IBS) and 45 age and sex matched healthy controls. NUD subjects had significantly higher total MHQ scores (28.8 +/- 11.3; p < 0.001) and scores in subscales of somatization (7.8 +/- 3.4; p < 0.001) and hysterical personality traits (5.5 +/- 2.8; p < 0.01) compared to healthy controls. MHQ scores in IBS subjects was significantly higher than in NUD, but in PUD subjects it was in-between NUD and healthy controls. Psychiatric morbidity, as assessed by Brief Psychiatric Rating Scale, was significantly higher in patients with NUD and IBS than in normal controls. Stressful Life event score was statistically similar in all the groups.
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PMID:Neuroticism and stressful life events in patients with non-ulcer dyspepsia. 928 68

Functional gastrointestinal disorders are best understood by applying a bio-psycho-social model. The diseases are strongly associated with psychological factors, and in functional dyspepsia, low vagal activity might be a mediating mechanism by which psychological factors (like neuroticism and stress) influence gastrointestinal physiology and cause epigastric discomfort. Low vagal activity may be a manifestation of stress and a cause of impaired gastric accommodation to meals. Epigastric discomfort is elicited when the stomach is distended without prior (vagal) reflex relaxation. Conventional therapy for acid-related dyspepsia does not improve accommodation and hence, is ineffective. The beneficial effect of experimental therapy, like glyceryl trinitrate and sumatriptan, which improve gastric accommodation, gives very good prospects for further development. For patients with irritable bowel syndrome, today's therapy seems similarly inefficacious, but several new potentially effective drugs are at present undergoing clinical trials.
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PMID:Today's therapy of functional gastrointestinal disorders--does it help? 1002 81

140 patients with the irritable bowel syndrome were examined. According to the results of clinical analysis of the manifestations, symptomatology and structure of comorbidity, two syndrome types were identified. These included those: with the phenomena of autonomic or conversive neurosis (89.3 and 10.7% respectively). The syndrome with signs autonomic neurosis were characterized by: 1) spontaneous or somatogenic manifestation; 2) homomorphism and stability of both abdominalgias and defecation disorders; 3) limitation of functional disorders in gastrointestinal organs; 4) syndromal and temporary (parallelism of formation and dynamics) comorbidity with endogenous diseases (66%) (cyclothymia, slowly progressive schizophrenia), hypochondriac development (16%) and anxious-phobic disorders (18%); 5) correlation with subclinic somatic pathology of gastrointestinal tract. Syndrome with the phenomena of conversive neurosis was characterized by: 1) psychogenically induced manifestation; 2) polymorphism and instability of abdomnalgias and stool disorders; 3) polymorphism of functional disorders of different organ systems; 4) syndromic and temporary (parallelism of formation and dynamics) comorbidity with subsyndromic psychic disorders: transitent hysterohypochondriac phobias (cardiophobia, tanatophobia)--60%, transitent (less than 2-3 months) hysteroaffective reactions caused by situations--40%; 5) none or minimal concomitant subclinical gastrointestinal pathology.
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PMID:[The irritable bowel syndrome in mental patients]. 1124 82

The authors have evaluated the quality of life of 120 persons in three equal groups (those with irritable bowel syndrome, those with neurosis but no psychosomatic symptoms and healthy individuals). The Scale of Quality of Life constructed on the basis of the Rotterdam Symptom List, was applied. The authors have also observed the changes that took place in the noted quality of life in the course of therapy. The major conclusion that arises from this study is the following: in the case of irritable bowel syndrome, psychotherapy should be used besides typical pharmacological treatment.
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PMID:[Quality of life in patients with irritable bowel syndrome]. 1264 57

The available evidence from randomized clinical trials or meta-analyses on the therapeutic efficacy of psychotropic drugs and, specifically, of antidepressants, in functional gastrointestinal disorders (FGD), are recent and still fairly limited. The use of these drugs is based on the frequent association of anxiety and depression or neurosis in patients with FGD who seek medical care and on the demonstrated efficacy of these drugs in relieving chronic pain, whatever its origin or localization, for more than 30 years. Antidepressants, even in doses under the antidepressant range, are antinociceptive due to their central and peripheral neuromodulatory effect, which is completely independent of anticholinergic, spasmolytic or antidepressant effects. This has been demonstrated in both animals and humans and, as occurs with another antinociceptive drugs such as clonidine, is mediated by alpha-adrenoreceptors. The choice of antidepressant depends both on the evidence of its analgesic activity (in general greater with tricyclic antidepressants than with the more modern selective serotonin reuptake inhibitors) and on the presence of drug-related adverse effects, which include not only anticholinergic adverse effects but also the possibility of hypotension or cardiotoxicity, which should be avoided. The main selection criteria are demonstrated efficacy and safety. Antidepressants have been shown to be effective in the specific field of non-coronary chest pain probably originating in the esophagus unrelated to gastroesophageal reflux disease, especially mianserin and trazodone, and the effect is maintained in the long term in nearly three-quarters of treated patients. Tricyclic antidepressants have also been shown to be effective in the treatment of abdominal pain in patients with irritable bowel syndrome, with an OR of 4.2 and an NNT of 3.2 in comparison with placebo. In contrast, there is insufficient evidence to recommend the use of antidepressants in functional dyspepsia.
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PMID:[Antidepressant therapy in functional gastrointestinal disorders]. 1618 84


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